Presentation description

Native American mothers experience disproportionately high maternal mortality compared to other racial and ethnic groups. CDC data suggest that 93% of these deaths are preventable, with suicide and overdose deaths among the leading causes. The Culturally Engaged REcovery - MOms connected through Native CommunitY (CEREMONY) project aims to develop, implement, and evaluate a culturally integrated perinatal substance use disorder (SUD) program adapted from an existing integrated perinatal SUD care model at the University of Utah. The intervention will be developed in partnership with Sacred Circle Healthcare, a health entity owned and operated by the Confederated Tribes of the Goshute Reservation. Using the ADAPT-ITT (Assessment, Decision, Adaptation, Production, Topical Experts, Integration, Training, Testing) model, a Community Advisory Board (CAB) identified facilitators and barriers to CEREMONY that could be amplified or mitigated, respectively. After four meetings in Spring 2024, the CAB identified 63 facilitators and 71 barriers. CAB members voted on the importance of these barriers/facilitators, and mean priority scores and frequency of selection were recorded and analyzed. The CAB highlighted holistic SUD care, patient safety, social services, and transportation as facilitators, while noting childcare, rural access, cultural diversity, stigma, and trust as barriers. Using validated feasibility and acceptability surveys and focused discussion, the CAB identified a group prenatal care model as the most likely to address these barriers and facilitators. This analysis highlights a successful, community-engaged adaptation process that has identified a clinical model to provide culturally-responsive SUD care at a Tribally-owned health facility.